Chest
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Randomized Controlled Trial Comparative Study Clinical Trial
Suction vs water seal after pulmonary resection: a randomized prospective study.
To evaluate whether suction or water seal is superior in the management of chest tubes after pulmonary resection. ⋯ Placing chest tubes on water seal after a brief period of suction after pulmonary resection shortens the duration of the air leak and likely decreases the time that the chest tubes remain in place. Adoption of this practice may result in lower morbidity and lower hospital costs.
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Major pulmonary embolism (PE) results whenever the combination of embolism size and underlying cardiopulmonary status interact to produce hemodynamic instability. Physical findings and standard data crudely estimate the severity of the embolic event in patients without prior cardiopulmonary disease (CPD) but are unreliable indicators in patients with prior CPD. ⋯ Spiral CT scanning is evolving to replace angiography as a confirmatory study in this population. Thrombolytic therapy is acknowledged as the treatment of choice, with embolectomy reserved for those in whom thrombolysis is contraindicated.
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Randomized Controlled Trial Clinical Trial
A randomized clinical trial of intermittent subglottic secretion drainage in patients receiving mechanical ventilation.
To study the effect of subglottic secretions drainage on the incidence of ventilator-associated pneumonia (VAP) in patients receiving mechanical ventilation. ⋯ Intermittent subglottic secretion drainage reduces the incidence of VAP in patients receiving mechanical ventilation.
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To evaluate the influence of silver-coated endotracheal tubes on the lung bacterial burden of mechanically ventilated dogs. ⋯ These results suggest that the silver coating of endotracheal tubes may delay the onset of and decrease the severity of lung colonization by aerobic bacteria. Based on these results, clinical studies are planned to determine the safety and clinical efficacy of silver-coated endotracheal tubes in patients requiring mechanical ventilation in the ICU setting.